Mandible position indicator for analyzing bite function

ABSTRACT

A system and method for capturing movement of the mandible. A top pantograph is fixed to a patient, wherein fixing includes attaching clutches to the top teeth of the patient. A bottom pantograph is fixed to the patient, wherein fixing includes attaching clutches to the bottom teeth of the patient. Movement of the bottom pantograph relative to the top pantograph during the patient&#39;s bite cycle is monitored and a hinge axis corresponding to the patient&#39;s mandible is determined.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/052,497, entitled “Mandible Position Indicator for Analyzing BiteFunction”, filed Oct. 11, 2013, which is a continuation of U.S. patentapplication Ser. No. 13/671,269, entitled “Mandible Position Indicatorfor Measuring and Replicating Occlusion,” filed Nov. 7, 2012, which is acontinuation-in-part of U.S. patent application Ser. No. 12/714,164,entitled “Mandible Position Indicator and Automatic Articulator forMeasuring and Replicating Occlusion,” filed Feb. 26, 2012, now issued asU.S. Pat. No. 8,348,667, which claims the benefit of U.S. ProvisionalApplication No. 61/156,373, filed Feb. 27, 2009, the disclosure of eachof which is incorporated herein by reference in its entirety.

This application claims the benefit of U.S. Provisional Application No.61/619,667, filed Apr. 3, 2012, the disclosure of which is incorporatedherein by reference in its entirety.

BACKGROUND

Dental care providers may create a three dimensional (“3D”) physicalmodel or cast of one or more areas of a patient's oral cavity. With a 3Dphysical model, a care provider can interact with the model to quicklyview multiple angles of the model and to visualize adjustments made tothe model. For example, care providers may create a model of an area ofa patient's oral cavity where one or more teeth are missing or damaged,so that suitable replacement teeth may be made in the lab using themodel as a guide.

Proper fitting the lab-made teeth would benefit from an understanding ofhow the teeth are used by the patient. In other words, somehow linkingthe model to the mechanics of the patient's bite is desirable. In thepast, care providers have used a mechanical device called an articulatorin conjunction with the models to replicate movement of the patient'smandible about a bite axis. This is a crude replication of the bite andoften fails to capture intricacies of the bite motion, includinghabitual adaptation of the bite to malformations of the teeth. Habitualadaptation of the bite often occurs via muscle training In addition tofailing to capture the complex curvature of the bite, the known methodsare imprecise and inaccurate, as the care provider is often mounted tosoft tissue, record data via a pen, or introduce error during differentportions of a procedure. Articulators are manually adjusted based onrecorded data. This provides two windows for errors. A third window forerror is in model creation. What is needed is a system which canaccurately and precisely capture bite motion and simulate bite motion sothat a care provide can better study bite motion. To reach a betterunderstanding of a patient's physiology and proposed care options, careproviders have expressed a desire to be able to study bite motionphysically, rather than in 2 dimensions.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings illustrate generally, by way of example, variousembodiments discussed in the present document. The drawings are forillustrative purposes only and may not be to scale.

FIG. 1 is an illustration of a digital bite information collectionapparatus 100, according to some embodiments.

FIGS. 2A-B illustrate clutches and a condylar axis, according to someembodiments.

FIGS. 3A-B show a pantograph in two separate positions.

FIG. 3C illustrates movement in the horizontal sensor field.

FIG. 4 illustrates a portion of a pantograph that includes a laser 402that is split into a first beam 404 parallel the left-right axis, and asecond beam 406 parallel the dorsal-ventral axis, according to someembodiments.

FIG. 5 illustrates an MMS 200, according to some embodiments. A cast ofthe top teeth is coupled to the top bad 202, according to someembodiments.

FIG. 6 illustrates an example system and method for transfer of bitinformation to MMS without a jig, according to some embodiments.

FIG. 7 illustrates a MMS, according to some embodiments.

FIG. 8 shows a further portion of an MMS, according to variousembodiments.

FIG. 9 illustrates a further MMS, according to some embodiments.

FIG. 10 illustrates a table on which the device of FIG. 9 can bemounted, to gain motion along axis A10, 1, according to someembodiments.

FIG. 11 is a perspective view showing the underside of a bottomarticulator plate, according to some embodiments.

FIG. 12 illustrates a further MMS, according to some embodiments.

FIG. 13 illustrates a perspective view of the capture plate 1208,according to some embodiments.

FIG. 14 is a block diagram illustrating an example of a machine uponwhich one or more embodiments may be implemented.

FIG. 15 is a method of modeling a bite, according to an example.

FIG. 16 is a method of creating a bite model, according to an example.

DETAILED DESCRIPTION

In the following description, reference is made to the accompanyingdrawings that form a part hereof, and in which is shown by way ofillustration specific embodiments which may be practiced. Theseembodiments are described in sufficient detail to enable those skilledin the art to practice the invention, and it is to be understood thatother embodiments may be utilized and that structural, logical andelectrical changes may be made without departing from the scope of thepresent invention. The following description of example embodiments is,therefore, not to be taken in a limited sense, and the scope of thepresent invention is defined by the appended claims.

The present subject matter provides an improved system and method forcapturing dental articulation. It allows care providers to understandarticulation, create models of that articulation, find improvedarticulation if possible, and provide treatments based on the modelsthat will either allow the existing articulation or encourage theimproved articulation.

The following benefits are recognized. First, the present subject matterbetter captures bite motion by fixing measuring tools to both the topand bottom teeth. This is preferred over systems that fix to only onerow of teeth, as it reduces error. Systems that fix to only one row ofteeth inevitably fix the other portion of a bite monitoring system tosoft tissue, which can result in error via tissue movement or some othererror. This problem is discussed herein. Improvements over this approachby the present subject matter include actually replicating the functionof the condylar axis, as well as eliminating the reliance on soft tissueor some other error prone data in establishing the geometricrelationship of both rows of teeth to one another throughout a range ofmandibular articulations.

Second, the present subject matter better simulates motion by usingdigital data to replicate a bite motion on an improved automatedarticulator, which can include a Stewart platform. By recording bitemotion in a digital format, and then simulating the bite motion usingthe digital motion, at least one opportunity for error is eliminated.One opportunity for error is eliminated because data from the monitor istranscribed to the articulator digitally, rather than being replicatedby hand adjustments to the articulator.

FIG. 1 is an illustration of a digital bite information collectionapparatus 100, according to some embodiments. The system includes a topface bow 102 coupled to a top clutch 106. The top clutch can be coupledto a top teeth and optionally gingivia of a patient, such as by using aquick setting, compliant compound that can both capture the shape of theteeth and which can be released from the teeth. The system 100 furtherincludes a bottom face bow 104 coupled to a bottom teeth 108, which canhave a compound disposed in it just as the top face bow 102 does.

When mounted, the care provided can adjust the face bows 102, 104 sothat a first sensor 110 registers with both an anterior-posterior sensorfield 112 and a horizontal sensor field 114. This adjustment canoptionally be performed using adjustable sliders 150A-D. This allows thetool to fit to persons in different stages of development.

The first sensor 110 is a laser in some embodiments, but the presentsubject matter is not so limited. Other optical sensors can be used. Thesensor fields can include position sensitive diodes (“PSDs”), but thepresent subject matter is not so limited. To save cost, the illustratedembodiment uses a laser splitter to direct laser light from one laser toboth sensor fields 112, 114, but the present subject matter is not solimited.

FIGS. 2A-B illustrate clutches and a condylar axis, according to someembodiments. The present subject matter accurately and preciselycaptures D1 and D2 by running the laser, broadcasting laser lightagainst a sensor plane, and digitizing and storing the informationcaptured digitally in a measurement computer for analysis and display.

FIGS. 3A-B show a pantograph in two separate positions. As the patientmoves their mandibles from the position illustrated in FIG. 3A to theposition illustrated in FIG. 3B, the lasers trace a path 118 of laserlight against a plurality of sensor planes, and this path is captureddigitally. The precision is to at least 0.0001 of an inch. This path canbe in the anterior-posterior/dorsal-ventral plane, and/or it can be inthe anterior-posterior/left-right plane, as illustrated by the path 130traced in FIG. 3C. This is an improvement over systems that use stylusesand pens which have to be changed after each recording. This approachallows for iterative captures, which can statistically improve certaintythat the path of interest is desired. This information is used to studythe patient and to provide therapy to the patient. In some embodiments,a measurement computer monitors data and issues an alert to a careprovider when a specific degree of statistical certainty so to the arcof the jaw is determined.

FIG. 4 illustrates a portion of a pantograph that includes a laser 402that is split into a first beam 404 parallel the left-right axis, and asecond beam 406 parallel the dorsal-ventral axis. Adjustments can bemade using one or more thumb screws (or some analog) to move the laserin relation to a second pantograph along one or both of the 4X axis andthe 4Y axis.

Axis of Rotation, Excursions, “Natural Path”

One procedure contemplated herein studies mandibular function. Thisprocedure is useful to understand the bite bath as mandated by thecondyle, and not the teeth. This “natural path” is the path that wouldbe experienced but for teeth interfering with the bite.

During approximately 20 to 25 mm of opening or closing of the mouth fromand to contact of the teeth, the mandible rotates around an axis ofrotation A1, which is located in the condyle. This is often referred toas a “hinge movement,” and therefore, this axis is called the “hingeaxis.” When the condyles are in their anterior-superior, “seated”position in the mandibular fossae, this axis is called the “terminalhinge axis.” This is understood to be the physiologic position fromwhich “mandibular movements” or “excursions” start. A “mandibularmovement” might be opening the mouth, moving the mandible in an anteriordirection or moving the mandible in a right or left excursive movement.

The teeth of some patients are arranged such that when they bite intheir normal, day to day occlusion (intercuspal position or habitualocclusion), the condyles are in the normal, anterior-superior locationin the mandibular fossa and therefore, the axis of rotation is also inthe normal location. However, one problem is that the teeth of somepatients are arranged such that when they bite in their normalday-to-day occlusion, the condyles are not in the anterior-superiorlocation in the mandibular fossae, and therefore the axis of rotation isat some variance from that which is considered physiologic.

The problem noted above becomes more obvious when the person experiencesa related “problem” in the form of “muscle splinting” or cramping. Whenthe occlusion is not in harmony with the physiologic position of thecondyles, the muscles must move the mandible to the position where theirteeth will bite in their normal day today bite (habitual occlusion). Ifthe muscle activity is beyond their capacity to tolerate this function,they start to hurt.

A second problem occurs if the person's axis of rotation is located atsome variance from the desired location. When the mandible is moved in alateral excursion, the patient moves in a habitual pathway that works.The muscles navigate the mandible in the pathway in which“interferences” or obstacles do not occur. However, during sleep or atvarious times such as resting with the teeth slightly apart, thecondyles tend to seat in their physiologic position, and then when themandible moves in an excursion, or the “natural path,” a problem occursin that the teeth experience “interferences,” or problematic toothcontacts. This results in abnormal tooth wear, called “facets.” Ifsevere, these interferences result in bone loss, a need for a “rootcanal treatment,” muscle splinting, temporomandibular joint disordersand other problems. Patients attempt to counter these afflictionsthrough habitual adaptation, i.e. muscle training

A problem also can occur during the treatment process of fabricating andplacing a prosthetic dental item, such as a crown or a bridge. If theocclusal (biting surface of a tooth) surface of a gold or porcelaincrown is not designed and formed in a manner that provides for both thehabitual and physiologic (natural) function, the patient may experiencedifficulty in the form of tooth pain, muscle pain, tm joint paint andheadaches. Therefore, in addition to simple day-to-day functionproblems, there is the potential for treatment problems if a dentalprovider does not address the matters of axis of rotation and excursivemandibular movement.

If a dental provider is treating the entire occlusion, then it ismandatory that the axis of rotation, or hinge axis is located, recordedand transferred to an appropriate instrument on which the prostheticitem is to be fabricated. The present subject matter performs thisfunction.

Some instruments do not locate the axis of rotation accurately and aredifficult and time consuming to use. In addition, quite often aninstrument is used to determine an “arbitrary” or “estimated” axis ofrotation. In this method, some device is used to locate a point 13 mmanterior to the tragus of the ear on a line from the tragus to the outercanthus of the eye. This has been determined to approximate the locationof the axis of rotation. The problem is that this is only a poorestimation of the actual axis of rotation, and it could vary fromone-half a millimeter to two or three millimeters. There will always besome degree of error when an “estimated axis” is used. Therefore, it iscritical to accurately locate the physiologic axis of rotation whentreating the entire occlusion with a full-mouth reconstruction,orthodontic treatment or any treatment that involves the entireocclusion. Known solutions are inaccurate, difficult to use and consumean inordinate amount of time in use. The present subject matteraddresses these problems.

One way the present subject matter addresses these problems is byallowing the care provider to understand the natural path and thehabitual path in operation of an articulator. The present subjectmatter, through tooth scans, can digitize bite motion and store anddisplay that on a measurement computer, in conjunction with an actualbite. This could be done by replacing the adjusters 150 with lineardistance monitors. Then a measurement computer would have scanned teethand would understand the bite via data received from the system 100.

The present subject matter additionally allows modeling of natural pathand habitual path via an 3D bench top articulator. This articulator, asdisclosed herein in relation to various embodiments, uses servo motorsto move the mandibles in relation to one another to simulate a bite viathe methods set out above.

Centric Relation Bite Registration

If the patient has soreness or pain in the muscles of mastication or ifthe patient has a temporomandibular (“TM”) joint disorder, one shouldresolve those problems prior to attempting to accomplish a centricrelation bite registration. One can to the bite registration, but itmost likely will not be accurate.

The process for resolving muscle soreness or pain or symptoms of a TMjoint disorder may involve the use of an occlusal splint (a plasticdevice that fits over the teeth to provide proper occlusion function inorder to allow healing) for several months. Other measures such asphysical therapy may be involved as well.

If the patient does not have soreness or pain of the muscles ofmastication and does not have a TM joint disorder or if the patient hashad these problems resolved, then one proceeds with the biteregistration, which is described below.

In using the anterior stop technique, one can prepare a four thicknesspiece of occlusion wax that provides for the width of the maxillaryanterior teeth and that provides for contact with the mandibularincisors. Generally, this piece of wax will be 1½ inches long, ½ to ¾inches wide and ½ inches deep. Heat the wax in a water bath at 140degrees.

Prepare a two thickness piece of occlusion wax (the posterior piece)that provides for the width of the maxillary first molars at theirbuccal surface. Generally, this piece of wax will be 3 to 4 inches long,1 inch wide and ⅜ inches deep. Heat the wax in a water bath at 140degrees.

Attached the system 100 to the patient. After instruction the patientregarding the procedure, place the dead soft anterior piece of wax onthe maxillary anterior teeth. With the thumb on the patient's chin, theindex finger under the left gonial angle of the mandible and the middlefinger under the right gonial angle of the mandible, manipulate thepatient's mandible to cause an arcing motion of four to eightmillimeters while applying only an upward pressure at the gonial angles.As this is being accomplished, one should feel the mandible seating in“rest position,” or that position of the mandible one would find it tobe when the muscles of mastication are not active. The purpose of theupward pressure is only to sense if the patient moves the mandible outof rest position. The manipulation must start at rest position and thecondyles must not be allowed to move out of their seated position. Asthis is being accomplished, one will note a smooth and freely arcingmotion to the mandible. The patient is instructed to let the lowerincisors strike the wax. Then the patient is instructed to “squeeze” and“bite slowly.” The care provider instructs the patient to stop bitingwhen the maxillary and mandibular posterior teeth are about 1½ to 2millimeters from contact. The posterior teeth cannot contact at anypoint or the patient will move the mandible to their habitual occlusionand the bite registration is invalid. If the procedure is satisfactory,the anterior wax piece is cooled with air from an air syringe, the pieceis held in place while the patient is instructed to open, and the waxpiece is place in ice water.

After the anterior wax piece has hardened in the ice water, the deadsoft posterior wax piece is placed on the maxillary first molars,extending across the palate. The wax is pressed onto the occlusalsurface and held in place. Then the cold, hard anterior wax piece isreplaced on the maxillary anterior teeth.

Optionally, the wax is coupled to the clutches 104, 106 so that thesystem 100 can record the relation of the teeth to the axis when thesystem is engaged to record. One input to record could be a foot pedal,but the present subject matter is not so limited.

During a recording period, the care provider places the fingers on thechin and the gonial angles as before and manipulates the mandible in thesame manner, watching carefully to be certain the mandibular incisorsfit into the registration imprints in the wax.

If the incisors fit, during another recording period, the patient istold to “squeeze” and then “bite hard evenly on both sides.” During thisbiting, the muscles of mastication (primarily the masseter and internalptyergoid muscles) seat the condyles in a physiologic, seated position,which is understood to be in a superoanterior location in the mandibularfossae. This position can be recorded.

The posterior wax piece is cooled with air from the air syringe, theposterior piece is held against the maxillary molars and the patient isinstructed to “open.” The anterior and posterior wax pieces are floatedin water to prevent distortion. The centric relation wax biteregistration (2 pieces) together with a proper transfer of the condylaraxis via the system 100 are used to mount the dental models in one ormore dental articulators.

Centric relation is defined as the relative location of the mandiblewhen the condyles and their properly attached articular discs areactively positioned by the closing musculature against thesuperoanterior areas of the posterior slopes of the articular eminencesof the mandibular fossae and are also physiologically positionedtransversely.

The models are “mounted in centric relation.” This is an improved mount.When combined with the improved determination of the condylar axis asset out herein, including but not limited to excursion and path datafrom the system 100, superior and highly accurate and preciserepresentation on an articulator can take place.

Systems and Methods for Recording Mandibular Movement

A care provider can select clutches, upper, and lower. The care providercan fill upper and lower clutches with medium such as a wax. The careprovider can fit the clutches to respective teeth. In optionalembodiments, the care provider can align right and left sensor ear canalindicators to ear canals. In some embodiments, the care provider can fitlower clutch in alignment to upper clutch. In some embodiments, the careprovider can fasten upper face bow to upper clutch, aligning in ahorizontal plane. In some embodiments, the care provider can fastenlower face bow to lower clutch, aligning in a horizontal plane. Inoptional embodiments, the care provider can align right and left lasersto indicators.

In various embodiments, the care provider can power on a measurementcomputer, upper face bow and lower face bow and check all lasers and PSDsensors function and wireless communication with the measurementcomputer. In some embodiments, the care provider can position a patientin chair in upright sitting position. In some embodiments, the careprovider can instruct patient to make random movement to test systemfunction. In some embodiments, the care provider can have patient openand close their jaw several times while recording using the laser. Insome embodiments, the care provider can check to see if hingerecordings, right and left sensors overlap. If not, in some embodiments,the care provider can optionally erase recordings and repeat hinginguntil the recordings overlap. The care provider may be able to eraserecordings and repeat hinge only once. The system can optionallycalibrate so that the hinge arcs substantially overlap (e.g., less than5% different in amplitude along arc).

In various embodiments, the care provider can check arcs described bylaser-on-sensors on, for example, a monitor. The arcs could optionallybe stored in a memory for use by another device, such as a processor ina Mandibular Movement Simulator (“MMS”) computer, as disclosed herein.In some embodiments, the care provider can query the measurementcomputer to show origin of arc radii with, for example, a blinking dotor target. In some embodiments, the care provider can repeat operationwith different color dot to confirm duplicate result. The measurementcomputer could also duplicate the result or calculate statisticalcertainty via a number of iterations.

In some embodiments, the care provider can reposition horizontal laserbeams, right, and left, to arc radii origins, as indicated and verifiedby the measurement computer. In some embodiments, the care provider canreposition vertical sensors on right and left sides of pantograph toalign axial centers on sensors, to be coaxial with laser beams asindicated and verified on the measurement computer display and/or via areoccurring sound that increases in frequency as the tool is moved intoadjustment. In some embodiments, the care provider can choose to magnifyresult on monitor, and query the measurement computer if any errors, oranomalies are indicated. If there are anomalies, the care provider couldstore them with a flag. If they do not, the care provider may have thepatient make several protrusive movements while recording, and savethose recordings.

In various embodiments, the care provider may have patient make severalpasses of right excursive movement, while recording. Optionally, theycan check if recordings overlap. If they do not, the care provider cantroubleshoot by checking equipment and adjusting or calibrating eitherthe sensors in relation to one another or the pantograph in relation tothe patent. The care provider can optionally make a note and save thatnote in relation to the record. Also, they can have patient make severalpasses of left excursive movement, while recording. The care providermay check if recordings overlap. If they do not, the care provider maytroubleshoot. If they do, the care provider may note this and save thedata relating to success and to the actual motion in a database inrelation to the note.

The care provider may remove upper face bow, with clutch intact and setit aside. The care provider may remove lower face bow, with clutchintact and set it aside. They can take impressions of upper and lowerarches. They can pour upper and lower impressions with hard stone andtrim.

Jig System and Method

They can mount upper an pantograph bow to a Mandibular MovementSimulator (“MMS”) mounting jig. They can mount lower pantograph bow toMMS the mounting jig. The lasers are aligned to targets (e.g., sensors)on the jig. The upper and lower pantograph bows can optionally be lockedtogether. The care provider replaces the upper and lower clutches intorespective positions in the pantographs. Use pantograph to mount upperand lower trimmed stone casts to the Mandibular Movement Simulatormounting jig. At this point, the casts are mounted in a jig, andcondylar axis data is also stored on the jig. This jig could be fit to ahand articulator and used to align the casts to that articulator.

Optionally, the care provider can transfer mounted casts or molds to anMMS. This is a device that is controllable in 6 axes to simulatemandibular movement. In other words, the machine can adjust the lowermandible via servo motors. The adjustment can be along theanterior-posterior axis, around that axis, along the dorsal axis andaround that axis, and along the left-right axis and around. The hingeaxis is substantially parallel to the left-right axis.

The upper and lower pantographs can be attached to the jig during thetransfer, or they can be used to store data relating the location of thehinge axis to the jig. Once this dimension is known, the jig can then becoupled to the MMS and the MMS can be calibrated to replicate movementaccording to the axis transported with the jig. This way, the careprovider does not have to buy two sets of pantographs and can leave oneat the measurement location and still replicate the motion at the MMS.If the care giver has one or more hand articulators, she can mount thejigs of different patients to different articulators and reconstructivework can be done for multiple patients simultaneously.

System and Method for Transfer to MMS Without Jig

In an additional embodiment, one that can eliminate the error associatedwith transfer of the hinge axis location information from themeasurement site, to a jig, and to the MMS, one can simply mount caststo the MMS, fit the pantographs to the MMS and the casts, and then havethe MMS cycle through motions until it can replicate the arc data that'sbeen stored in the measurement computer from the pantographs. It woulddo this using feedback. For example, if the laser does not record a paththat overlaps with the stored bite path, the simulated path is adjusted,until the simulated path replicates the stored path within a specifieddegree of tolerance.

MMS Algorithms

The MMS is a multi-mode system. Modes are selectable by a user toperform different functions. In various embodiments, the MMS can becontrolled to execute a program stored on the MMS computer to simulatenatural paths. In a further mode, it can be controlled to simulatehabitual paths. In a further mode, it can be controlled to find asimulated habitual path by starting with a natural path and forcingteeth to collide with one another.

In measuring bite, to find a natural path, habitual paths should besuppressed. If a patient has habitual paths, one or more of thefollowing methods can be used to erase it from the patient's musclememory: the patient can be numbed, or can have their jaw lockedtogether, or their bit modified with a splint. Once the bite is restoreit to a natural path, it can be recorded.

In embodiments where natural path is simulated, using the hinge axis asa reference, the MMS is operated to explore a normal range of mandibularmotion. The care giver can study the look of the mold as the systemranges through this motion. Restorations can be made, and one can ensurethat the natural path is preserved.

In additional embodiments, the care provider can execute a programstored on the MMS computer to find and record habitual paths. In thisalgorithm, the MMS attempts to move a casting through natural motions asdetermined during measurement. Interferences will be bumped into andrecorded. The machine will attempt new paths, and can report progress tothe care provider. This attempt to find new paths will simulate thepatient's effort to find habitual paths.

The MMS can move the castings through a natural path set ofpredetermined motions to determine what the habitual path is. This canoptionally be correlated with a predetermined habitual path that ismeasured with a wax bite or with the system 100, above.

As the habitual paths are found, the care provider can modify the teethof the cast to eliminate the need for the habitual path. This can aid inthe creation of improved restorations. The 3D nature of the processassists the care provider in modifying the casts by hand, which can savetime and money. Habitual paths that are determined can be stored in theMMS computer or elsewhere for later review.

FIG. 5 illustrates an MMS 200, according to some embodiments. A cast ofthe top teeth is coupled to the top bad 202. A cast of the bottom teethis coupled to the bottom pad 204. The servo box 206 contains servos tomove these pads in relation to one another along up to six degrees offreedom.

FIG. 6 illustrates an example system and method for transfer of bitinformation to MMS without a jig. In them embodiments, the system 100 isfitted to casts 208 and 210 that are coupled to the MMS. The pantographsare moved in relation to each other, and the laser 110 broadcasts a beamto sensor fields 112 and 114. The MMS can thus learn how to replicatethe measured bite motion by trying to model (e.g., curve fit) datamonitored from motion of the MMS to stored data, and adjusting themotion of the MMS accordingly.

FIG. 7 illustrates a MMS 700, according to one embodiment. The motors304, 306 and 308 move the bottom plate, to which a cast is mounted,along A71, A72 and A73, among others. The guide 302 supports rotation.In some embodiments, the guide 302 includes a bushing.

FIG. 8 shows a further portion of an MMS, according to variousembodiments. The system can move at least along axis A81, A82 and A83.Bearings 802, 804 and 806 support such rotation. A fixture 810 iscoupled to the MMS to provide further rotation ability.

FIG. 9 illustrates a further MMS 900, according to some embodiments. TheMMS includes linear motors 904, 906, 908 and 910. The system moves thebottom articulator plate 902, to which a cast is coupled, free to movealong the six degrees of freedom discussed above. A spherical joint 914and hinge joints 916 are coupled to the articulator plate 902 and assistin motion.

FIG. 10 illustrates a table on which the device of FIG. 9 can bemounted, to gain motion along axis A10, 1. Motion, in some examples,occurs via actuation of motor 904 to move along the axis. Linear motors904 and 906 as well as hinge joints 916 are illustrated coupled tobottom plate 902.

FIG. 11 is a perspective view showing the underside of a bottomarticulator plate, according to some embodiments. The general concavityof the bottom plate 902, on a side not shown, is further illustrated.

FIG. 12 illustrates a further MMS, according to some embodiments. Thedevice is show in cross section. In some embodiments, the device issymmetrical about the cross section. A tilt shaft 1202 can move inrelation to support ring 1204 to adjust the mount plate 1206 in relationto the support ring 1204. In various embodiments, a capture plate 1208is to pinch the support ring by drawing the mount plate 1206 to thecapture plate 1208, with the support ring in the middle. In variousembodiments, the support ring has a concavity to contain the mountplate, to which a cast is coupled. Accordingly, the support ring 1204 isshaped like a sphere portion, and the mount plate 1206 and capture plate1208 are conformed to the support ring 1204 to slide along the supportring 1204 while maintaining contact with the support ring.

FIG. 13 illustrates a perspective view of the capture plate 1208,according to some embodiments. The support ring's concavity 1302 isshown.

The tilt shaft 1202 can optionally be threaded, with the capture plate1208 threaded onto the tilt shaft 1202. FIGS. 12-16 illustrate furtherviews of the components of FIG. 12.

FIG. 14 illustrates a block diagram of an example circuit 1400 which canbe used in conjunction with any of the examples discussed herein. Thecircuit 1400 can operate as a standalone device or can be connected(e.g., networked) to other circuits. The circuit 1400 can form all or apart of a personal computer (PC), a tablet PC, a set-top box (STB), aPersonal Digital Assistant (PDA), a mobile telephone, a web appliance, anetwork router, switch or bridge, or any machine capable of executinginstructions (sequential or otherwise) that specify actions to be takenby that machine. The term “circuit” can include any collection ofcircuits that individually or jointly execute a set (or multiple sets)of instructions to perform any one or more of the systemologiesdiscussed herein, such as cloud computing, software as a service (SaaS),other computer cluster configurations. Insofar as circuit embodimentsinclude software, such software can reside on a machine readable medium.Software, when executed by hardware, can cause the hardware to perform afunction.

Circuit (e.g., computer system) 1400 can include a hardware processor1402 (e.g., a central processing unit (CPU), a graphics processing unit(GPU), a hardware processor core, or any combination thereof), a mainmemory 1404 and a static memory 1406, some or all of which cancommunicate with each other vian an interlink (e.g., bus) 1408. Thecircuit 1400 can further include a display unit 1410, an alphanumericinput device 1412 (e.g., a keyboard), and a user interface (UI)navigation device 1414 (e.g., a mouse). The display unit 1410, inputdevice 1412 and UI navigation device 1414 can be a touch screen display.The circuit 1400 can additionally include a storage device (e.g., driveunit) 1416, a signal generation device 1418 (e.g., a speaker), a networkinterface device 1420, and one or more sensors 1421, such as a globalpositioning system (GPS) sensor, compass, accelerometer, or othersensor. The circuit 1400 can include an output controller 1428, such asa serial (e.g., universal serial bus (USB), parallel, or other wired orwireless (e.g., infrared(IR), near field communication (NFC), etc.)connection to communicate or control one or more peripheral devices(e.g., a printer, card reader, etc.).

The storage device 1416 can include a machine readable medium 1422 onwhich is stored one or more sets of data structures or instructions 1424(e.g., software) embodying or utilized by any one or more of thetechniques or functions described herein. The instructions 1424 can alsoreside, completely or at least partially, within the main memory 1404,within static memory 1406, or within the hardware processor 1402 duringexecution thereof by the circuit 1400. In an embodiment, one or anycombination of the hardware processor 1402, the main memory 1404, thestatic memory 1406, or the storage device 1416 can constitute machinereadable media.

While the machine readable medium 1422 is illustrated as a singlemedium, the term “machine readable medium” can include a single mediumor multiple media (e.g., a centralized or distributed database, and/orassociated caches and servers) that configured to store the one or moreinstructions 1424.

The term “machine readable medium” can include any medium that iscapable of storing, encoding, or carrying instructions for execution bythe circuit 1400 and that cause the circuit 1400 to perform any one ormore of the techniques of the present disclosure, or that is capable ofstoring, encoding or carrying data structures used by or associated withsuch instructions. Non-limiting machine readable medium embodiments caninclude solid-state memories, and optical and magnetic media. In anembodiment, a massed machine readable medium comprises a machinereadable medium with a plurality of particles having resting mass.Specific embodiments of massed machine readable media can include:non-volatile memory, such as semiconductor memory devices (e.g.,Electrically Programmable Read-Only Memory (EPROM), ElectricallyErasable Programmable Read-Only Memory (EEPROM)) and flash memorydevices; magnetic disks, such as internal hard disks and removabledisks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

The instructions 1424 can further be transmitted or received over acommunications network 1426 using a transmission medium via the networkinterface device 1420 utilizing any one of a number of transferprotocols (e.g., frame relay, internet protocol (IP), transmissioncontrol protocol (TCP), user datagram protocol (UDP), hypertext transferprotocol (HTTP), etc.). Embodiment communication networks can include alocal area network (LAN), a wide area network (WAN), a packet datanetwork (e.g., the Internet), mobile telephone networks (e.g., cellularnetworks), Plain Old Telephone (POTS) networks, and wireless datanetworks (e.g., Institute of Electrical and Electronics Engineers (IEEE)802.11 family of standards known as Wi-Fi®, IEEE 802.16 family ofstandards known as WiMax®), peer-to-peer (P2P) networks, among others.The network interface device 1420 can include one or more physical jacks(e.g., Ethernet, coaxial, or phone jacks) or one or more antennas toconnect to the communications network 1426. The network interface device1420 can include a plurality of antennas to wirelessly communicate usingat least one of single-input multiple-output (SIMO), multiple-inputmultiple-output (MIMO), or multiple-input single-output (MISO)techniques. The term “transmission medium” shall be taken to include anyintangible medium that is capable of storing, encoding or carryinginstructions for execution by the circuit 1400, and includes digital oranalog communications signals or other intangible medium to facilitatecommunication of such software.

The example circuit 1400 can include a digital bite replicator. Theexample circuit 1400 can include a computer such as to store a measureddistance. Sensors 1421 can include sensors 110 in FIG. 1. Examplesherein provide a digital dental diagnostic system.

FIG. 15 is a method 1500 of modeling a bite, according to an embodiment.At 1502, the method can include fixing a top pantograph to a patient viaclutches to the top teeth of the patient. At 1504, the method caninclude fixing a bottom pantograph to a patient via clutches to thebottom teeth of the patient. At 1506, the method can include opticallymonitoring the actual bite of the patient by monitoring the relation ofthe top pantograph to the bottom pantograph during a bite cycle. At1508, the method can include storing bite data relating to the actualbite. At 1510, the method can include storing patient data including athree-dimensional model including a top teeth model and a bottom teethmodel. At 1512, the method can include storing a digital top pantographmodel associated with the top pantograph. At 1514, the method caninclude storing a digital bottom pantograph model associated with thebottom pantograph. At 1516, the method can include digitally pairing thebite data, the top pantograph model and the bottom pantograph model tothe patient data. At 1518, the method can include digitally modeling thebite by digitally moving the top teeth model with respect to the bottomteeth model in association with the stored bite data.

FIG. 16 is a method 1600 of creating a bite model, according to anembodiment. At 1602, the method can include fixing a top pantograph to apatient via clutches to the top teeth of the patient. At 1604, themethod can include fixing a bottom pantograph to a patient via clutchesto the bottom teeth of the patient. At 1606, the method can includeoptically monitoring the actual bite of the patient by monitoring therelation of the top pantograph to the bottom pantograph during a bitecycle and storing a hinge axis. At 1608, the method can include storingdata relating to the actual bite. At 1610, the method can includescanning the top teeth to create a top teeth model. At 1612, the methodcan include scanning the bottom teeth to create a bottom teeth model. At1614, the method can include digitally fitting a digital representationof the top pantograph to the top teeth and a digital representation ofthe bottom pantograph bottom pantograph to the bottom teeth. At 1616,the method can include recording the relationship of the top teeth modeland the bottom teeth model to the hinge axis. At 1618, the method caninclude digitally creating a bite model by recording the position of thetop teeth model in relation to the bottom teeth model while digitallymoving the top teeth model with respect to the bottom teeth model aroundthe hinge axis.

Optional methods can include replicating the actual bite digitally usingfeedback by comparing the bite data relating to the actual bite to themodeled bite. Optional methods can include storing the bite dataincludes communicating the bite data wirelessly to a measurementcomputer and storing the data therein. Optional methods can includestoring a scan of the top teeth and the bottom teeth in the measurementcomputer. Optional methods can include storing a scan of the toppantograph and the bottom pantograph. Optional methods can includedisplaying the bite on a display of the measurement computer. A displaycan include output readable by a computer. A display can include avisible display such as a video screen. Optional methods can includedetecting a bite anomaly with the measurement computer. Optional methodscan include flagging the bite anomaly and displaying the flag. Optionalmethods can include controlling an automatic articulator with themeasurement computer.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in that may bepracticed. These embodiments are also referred to herein as “examples.”Such examples can include elements in addition to those shown ordescribed. However, the present inventors also contemplate examples inwhich only those elements shown or described are provided. Moreover, thepresent inventors also contemplate examples using any combination orpermutation of those elements shown or described (or one or more aspectsthereof), either with respect to a particular example (or one or moreaspects thereof), or with respect to other examples (or one or moreaspects thereof) shown or described herein.

All publications, patents, and patent documents referred to in thisdocument are incorporated by reference herein in their entirety, asthough individually incorporated by reference. In the event ofinconsistent usages between this document and those documents soincorporated by reference, the usage in the incorporated reference(s)should be considered supplementary to that of this document; forirreconcilable inconsistencies, the usage in this document controls.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “An and B,” unlessotherwise indicated. In the appended claims, the terms “including” and“in which” are used as the plain-English equivalents of the respectiveterms “comprising” and “wherein.” Also, in the following claims, theterms “including” and “comprising” are open-ended, that is, a system,device, article, or process that includes elements in addition to thoselisted after such a term in a claim are still deemed to fall within thescope of that claim. Moreover, in the following claims, the terms“first,” “second,” and “third,” etc. are used merely as labels, and arenot intended to impose numerical requirements on their objects. Theabove description is intended to be illustrative, and not restrictive.For example, the above-described examples (or one or more aspectsthereof) may be used in combination with each other. Other embodimentscan be used, such as by one of ordinary skill in the art upon reviewingthe above description. The Abstract is provided to comply with 37 C.F.R.§1.72(b) to allow the reader to quickly ascertain the nature and gist ofthe technical disclosure. The Abstract is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription, with each claim standing on its own as a separate.

What is claimed is:
 1. A method of determining centric relation biteregistration, comprising: fixing a top pantograph to a patient, whereinfixing includes attaching clutches to the top teeth of the patient;fixing a bottom pantograph to a patient, wherein fixing includesattaching clutches to the bottom teeth of the patient; placing a firstpiece of a dental impression material on one or more anterior teeth;recording a bite on the first piece of dental impression material;hardening the first piece of dental impression material; placing asecond piece of dental impression material on one or more maxillarymolars; recording a bite on the second piece of dental impressionmaterial; hardening the second piece of dental impression material;placing the patient's condyles in a seated position by having thepatient bite the hardened first and second pieces of dental impressionmaterial; and recording movements around the patient's condylar axis.